Summary
Background and aim
Sitosterolemia, a rare genetic disorder characterized by profoundly elevated plasma
sitosterol concentrations, is associated with premature atherosclerosis in some individuals.
This study was conducted to evaluate if the modest sitosterol elevations seen in the
general population are also associated with the occurrence of coronary events.
Methods and results
A nested case-control study using stored samples from male participants in the Prospective
Cardiovascular Münster (PROCAM) study was performed. Each of 159 men who suffered
a myocardial infarction or sudden coronary death (major coronary event) within 10
years of follow-up in PROCAM was matched with 2 controls (N=318) by age, smoking status, and date of investigation. Analysis was performed using
conditional logistic regression. Plasma sitosterol concentrations were elevated in
cases compared with controls (4.94±3.44 μmol/L versus 4.27±2.38 μmol/L; P=0.028). The upper quartile of sitosterol (>5.25 μmol/L) was associated with a 1.8-fold increase in risk (P<0.05) compared with the lower three quartiles. Among men with an absolute coronary
risk ≥20% in 10 years as calculated using the PROCAM algorithm, high sitosterol concentrations
were associated with an additional 3-fold increase in the incidence of coronary events
(P=0.032); a similar, significant relationship was observed between a high sitosterol/cholesterol
ratio and coronary risk (P=0.030).
Conclusions
Elevations in sitosterol concentrations and the sitosterol/cholesterol ratio appear
to be associated with an increased occurrence of major coronary events in men at high
global risk of coronary heart disease. Further evaluations are warranted to confirm
these preliminary findings.
Keywords
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Article info
Publication history
Published online: July 29, 2005
Accepted:
April 12,
2005
Received in revised form:
April 8,
2005
Received:
December 16,
2004
Footnotes
☆Financial support: this study was supported by an unrestricted educational grant from Merck–Schering Plough Pharmaceuticals, North Wales, Pennsylvania, USA.
Identification
Copyright
© 2005 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
